Understanding Balance

• Muscle Weakness: Age-related muscle loss, known as sarcopenia, can lead to weakness, particularly in the lower body, affecting balance.
• Sensory Changes: Decline in vision, proprioception (awareness of body position), hearing loss, and vestibular function (balance organ in the inner ear) can impair balance.
• Neurological: Conditions such as, Parkinson's disease, stroke (CVA), Multiple Sclerosis, Amyotrophic Lateral Sclerosis, and neuropathy can disrupt the signals between the brain and muscles, affecting balance control.
• Medication Side Effects: Certain medications can cause dizziness or lightheadedness, increasing the risk of falls. The National Institute on Aging suggests speaking with your doctor regarding medication side effects.
• Environmental Factors: Slippery floors, flooring changes, poor lighting, stairs, pets (even though we love them!), ill-fitting slippers/shoes, and obstacles in the home environment can contribute to falls.

• Falls: Balance deficits are a leading cause of falls among the elderly, which can result in fractures, head injuries, and decreased mobility. According to the CDC, more than 1 in 4 adults over 65 fall each year (4).
• Fear of Falling: After experiencing a fall, older adults may develop a fear of falling again, leading to decreased physical activity, social isolation, poor quality of life and inability to participate in leisure activities. The fear of falling can have a significant negative impact on mental health. The fear of falling and actual falls can lead to a loss of confidence and independence in performing daily activities.
• Medical Changes: Due to immobility from fear or recent fall, many older adults become sedentary. A sedentary lifestyle can cause an increase in diabetes symptoms, obesity, cardiovascular disease, poor circulation, inflammation, depression and anxiety (5,6).

• Strength Training: Regular strength exercises, focusing on the lower body, can improve muscle strength and balance. Often older adults are hesitant to participate in weight training, however recent research suggests weight training has shown positive benefits for adults over 65. A tailored program to fit individual strength training needs is vital for accurate performance of strength training (7).
• Balance Exercises: Based on individual balance concerns, Tai chi, yoga, chair exercises, and specific balance exercises determined by the Physical Therapist can enhance proprioception and stability. An improved balance will reduce the risk of falls.
• Flexibility Training: Stretching exercises can improve flexibility, increase range of motion, increase circulation, decrease stress, improve posture, and many other benefits while reducing the risk of falls (8).

• Remove Hazards: Clear clutter, secure rugs, remove throw rugs, remove cords from walking spaces, and ensure adequate lighting to minimize tripping hazards and falls in the home.
• Grab Bars and Handrails: Install grab bars in bathrooms and handrails on staircases to provide support and stability. Make sure to have handrails and grab bars checked regularly to reduce the risk of malfunction.
• Adaptive Equipment: Consider using assistive devices such as canes or walkers for added stability, talk to your Physical Therapist or primary care provider regarding the need for assistive devices. There is a range of adaptive equipment available today to assist with multiple needs, reach out to your provider regarding your individual needs. A Physical Therapist can offer recommendations to make your life easier.

• Medication Review: Periodically review medications with healthcare providers to identify any that may cause dizziness or balance issues. Physical Therapists are not allowed to recommend any medication changes but may assist with side effects from them. Please speak with your healthcare provider regarding identified side effects or medication management.
• Vision and Hearing Tests: Regular eye and ear exams can detect changes in vision or vestibular function early on. Early detection of vision, hearing or vestibular loss can help prevent disease progression and assist with management of effects.
• Screening for Neurological Conditions: Routine screenings for conditions like Parkinson's disease or neuropathy can facilitate early intervention. Regular health checkups with individual providers can lead to early detection, which can drastically alter the progression of symptoms.

• Healthy Diet: A balanced diet rich in nutrients can support muscle strength and overall health. Eating a variety of fruits, vegetables, whole grains, and lean meat will provide the nutrient support your body requires to maintain health.
  
• Stay Hydrated: Dehydration can contribute to dizziness and fainting, balance deficits, poor circulation, mood changes, confusion and fatigue. It's essential to stay hydrated. Drinking at least 2 Liters of caffeine-free fluids per day will ensure the body has optimal hydration. - Avoid excess sugar.
  
• Footwear: Wear supportive, non-slip footwear to provide stability and reduce the risk of falls. Proper footwear is essential to maintain balance and decrease fall risk. If you are unsure about your current footwear choices, speak to your Physical Therapist regarding your concerns. A proper evaluation of the foot, standing posture, and gait analysis is critical for proper shoe choice. Don’t underestimate the importance of proper footwear.

Remember: No referral needed at FYZICAL Monroeville and free fall assessments!
2526 Monroeville Blvd. Suite 3
Monroeville, PA 15146
412-457-8200

• Older Adult Falls. Injury Facts. (2023, November 6). https://injuryfacts.nsc.org/home-and-community/safety-topics/older-adult-falls/#:~:text=According%20to%20the%20Centers%20for,were%20treated%20in%20emergency%20departments.
• Four types of exercise can improve your health and physical ability | National Institute on Aging. (n.d.). https://www.nia.nih.gov/health/exercise-and-physical-activity/four-types-exercise-can-improve-your-health-and-physical
• Real-life benefits of exercise and physical activity | National Institute on Aging. Real-Life Benefits of Exercise and Physical Activity. (n.d.). https://www.nia.nih.gov/health/exercise-and-physical-activity/real-life-benefits-exercise-and-physical-activity
• Centers for Disease Control and Prevention. (2023, September 6). Older adult falls data. Centers for Disease Control and Prevention. https://www.cdc.gov/falls/data/index.html
• Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean J Fam Med. 2020 Nov;41(6):365-373. doi: 10.4082/kjfm.20.0165. Epub 2020 Nov 19. PMID: 33242381; PMCID: PMC7700832.
• Değer TB, Saraç ZF, Savaş ES, Akçiçek SF. The Relationship of Balance Disorders with Falling, the Effect of Health Problems, and Social Life on Postural Balance in the Elderly Living in a District in Turkey. Geriatrics (Basel). 2019 May 17;4(2):37. doi: 10.3390/geriatrics4020037. PMID: 31108836; PMCID: PMC6630729.
• How can strength training build healthier bodies as we age? | National Institute on Aging. (n.d.-b). https://www.nia.nih.gov/news/how-can-strength-training-build-healthier-bodies-we-age
• La Greca S, Rapali M, Ciaprini G, Russo L, Vinciguerra MG, Di Giminiani R. Acute and Chronic Effects of Supervised Flexibility Training in Older Adults: A Comparison of Two Different Conditioning Programs. Int J Environ Res Public Health. 2022 Dec 17;19(24):16974. doi: 10.3390/ijerph192416974. PMID: 36554854; PMCID: PMC9779245.